Bowers/Daugherty (2008)
International Journal of Research in Choral Singing 3 (1)
Student Vocal Health 39
Self-Reported Student Vocal Use at a High School Summer Choral Camp
Judy Bowers, The Florida State University
James F. Daugherty, The University of Kansas
Abstract
The purpose of this study was to investigate
self-reported vocal health of high school choral
students electing to participate in a summer
choral camp. Choral participants (N=141) were
surveyed prior to beginning camp activities, and
then surveyed at the end of the rather intense
week of choral singing, to gauge any changes
they might perceive in their voices. Amount of
sleep was observed, with little change during
camp week. Vocal problems, however, were
reported significantly more after the intense
week of singing than at the beginning. Twelve
vocal health items were surveyed and six
significantly increased after one week of intense
singing: hoarseness, tiredness, dryness, throat
pain when singing, straining to sing, and more
effort needed to sing or talk. There were no
significant differences between reported ability
to sing loud/soft, high/low, throat clearing
mannerisms, or taking appropriate care of the
voice.
Results
indicated
students
lack
knowledge of the voice and its necessary care,
since vocally the self-reports suggested students
were significantly less healthy, but also believed
they were taking good care of their voices.
Summer music camps offer an array of
concentrated learning opportunities not typically
possible during a regular academic year. Choral
music camps, in particular, may include daily
singing in large choruses, elective participation
in small vocal ensembles, classes in such areas
as music theory and sight-singing, private voice
lessons, and a host of recreational and social
events. The potential impact of a music camp
experience on the vocal health of adolescent
student singers, however, remains largely unexamined.
A growing body of research has focused on
occupational voice health and voice use
problems among teachers (e.g., Askren, 2001;
Bernstorf & Burk, 1996; Gotaas & Starr, 1993;
Hendry, 2001; Kramer, 1994; Mattiske, et al.,
1998; Morton & Watson, 1998; Rantala &
Vilkman, 1999; Roy, et al., 2004; Russell, et al,
1998; Sapir, et al, 1993; Schwartz, 2006;
Simberg, et al., 2005; Smith, et al., 1997;
Sodersten, et al., 2002; Thomas, et al, 2007;
Thibeault, et al., 2004; Yiu, 2002). Overall, such
investigations have found that teachers in
general, and some groups of music teachers in
particular, may experience an array of voice
problems, ranging from voice fatigue to
dysphonia, associated with day in, day out voice
use in classroom teaching.
Roy, et al. (2004), for example, reported
teachers were more likely than other
professionals to contemplate career change
because of voice problems. Simberg, et al
(2005), found an apparent increase in the
prevalence of vocal symptoms among teachers
surveyed across a twelve-year period.
With respect to music teachers, Bernsdorf &
Burk (1996) found that elementary music
instructors participating in their study typically
encountered voice problems primarily because
of job expectations and teaching environments
contributing to misuse or overuse of their voices.
In an investigation of burnout and self-reported
vocal health among music teachers and other
educators (N=53), Hendry (2001) found a
significant majority of vocal music teacher
participants and almost half of instrumental
Bowers/Daugherty (2008)
International Journal of Research in Choral Singing 3 (1)
music teacher participants reported voice
problems. However, the highest frequency of
self-reported voice problems occurred among
non-music teachers participating in the study.
Schwartz (2006) examined the vocal health
of selected middle-school and high school choral
music teachers (N=51).
Overall findings
indicated reduction in the phonation capacities
of these choral teachers, particularly in terms of
measurements of frequency and intensity, when
compared to results of similar studies conducted
with participants from the general population.
Schwartz, moreover, found that choral directors
participating in her study did not realize they had
vocal problems.
Other studies have looked at groups of
university students, including pre-service music
teachers and choral singers, with respect to
voice health and particular self-reported
symptoms of potential voice problems (e.g.,
Hackworth, 2006; Sapir, 1996; Schwartz, 2005;
Simberg, et al., 2000; Simberg, et al., 2004).
Sapir (1996), for example, found among 159
university students surveyed that singers were
more likely than non-singers to report symptoms
of potential voice problems. Hackworth (2006)
surveyed 140 undergraduate music education
majors from 5 universities about their
perceptions of personal voice use and vocal
hygiene once they graduated and began fulltime
teaching. Among respondents, 91% believed
that a voice disorder either would or might affect
their careers.
One study (Scrimgeour & Meyer, 2002)
examined the effectiveness of a hearing
conservation and vocal hygiene program for
kindergarten students (N=66). Results indicated
significant increase in knowledge that potentially
could prevent acquisition of inefficient voice
habits in the future.
Although adolescence has been well
documented as a time of demonstrable voice
change and growth associated with the onset of
puberty (e.g., Barressi & Bless, 1984; Cooksey,
2000; Cooksey, Beckett, & Wiseman, 1984;
Gackle, 2000; Groom, 1984; Kahane, 1978),
only one study to date has looked primarily at
potential voice health problems among persons
25 years of age and younger, including
adolescent choristers, who regularly sing in
choirs. Deutsch, et al. (2002) surveyed singers
(N=129) participating in youth choirs in the
Wilmington, Delaware area with respect to selfreported vocal health, including particular voice
habits and behaviors. Participants in this study
reported voice problems at the time of the
Student Vocal Health 40
survey, which included, in order of decreasing
incidence, hoarseness (42.6%), fatigue (24.0%),
change in voice range (19.4%), tickling or
choking sensation (17%), volume disturbance
(16.3%), and breathiness (15.5%).
Over a third of these singers (43%) felt they
had to strain their voices when singing, while
31% reported a sensation of “over-singing” in
choral rehearsals.
Disaggregation of data
indicated no significant differences in reported
voice problems between those singers who had
private voice lessons and participants who had
never taken private voice lessons. Pubertal
adolescents responding to this survey,
moreover, reported a greater incidence of voice
problems than pre-pubertal singers.
Our search of the literature revealed no
investigation to date that focused upon potential
issues of voice health among adolescent
choristers participating in daily, intensive periods
of rehearsing, singing instruction, and social
activities such as may occur in week-long
summer music camp experiences. That is, while
potential voice health issues associated with
teaching in general and choral music teaching in
particular have been documented, potential
voice health matters among adolescent singers
with whom such teachers work appears to have
been less examined, especially in educational
contexts where there may be expectations for
prolonged, intensive voice use by adolescent
singers.
The purpose of this study was to examine
student perceptions of their vocal health before
and after an intense, though highly reinforcing,
week of choral music rehearsals in a traditional
choral summer camp.
To that end, the following research
questions were designed for this investigation:
1. What are students’ perceptions of their
vocal health prior to and at the conclusion of a
one week choral camp?
2. What might ex post facto analysis of
camp rehearsal schedule suggest about the
findings of student self reported vocal health?
METHOD
Participants
Participants for this study were students
attending a long established summer choral
camp at a major southeastern university for a
one-week residential experience (N=141) among
high school singers of similar commitment and
Bowers/Daugherty (2008)
International Journal of Research in Choral Singing 3 (1)
dedication. Recommended ages for participants
included boys rising into the ninth grade and
girls rising into the tenth grade, through grade
12, though several students attending were
outside these parameters.
Campers were
residents of 12 states, though the majority
resided within the home state and a neighboring
state.
Survey
Students electing a summer choral camp
were viewed as students strongly interested in
singing, though to varying degrees, with
expectations that some students would be highly
interested, perhaps planning to major in music
and pursue some form of musical career. Thus,
the survey solicited information about current
vocal health before and after the event, for
comparison. Survey questions were drawn from
reports of vocal study in the literature, such as
Deutsch, et al. (2002). Students provided
demographic information and then responded to
questions using a 7-point Likert-type scale,
indicating agreement or disagreement with each
statement.
Procedure
Surveys were completed immediately after
registration, during the camp orientation period.
Student schedules for the following five days
included a rather challenging daily schedule:
vocal warm up (20 minutes), men’s choir (50
minutes), women’s choir (50 minutes), mixed
choir (150 minutes), sight reading class (50
minutes), movement class (50 minutes), small
ensembles (50 minutes), with optional electives
in barbershop singing (60 minutes) and
handbells (60 minutes).
During the week,
though not daily, were other vocal opportunities
and responsibilities: one evening sectional
rehearsal (90 minutes), one staging rehearsal of
the choreographed finale (90 minutes), and for
those 24 students selected by audition to work
with the voice faculty, there were 30 additional
minutes of coachings and an evening recital
performance.
Posttest surveys were completed on Friday,
before the two final concerts. Students
completed a pretest survey on Sunday at
orientation (n=125) and followed with a posttest
survey completed on Friday, prior to the final
Saturday morning final concert (n=134).
Student Vocal Health 41
For the pretest, there were 84 girls and 41
boys responding (n=125) and for the posttest, 89
girls and 45 boys completed surveys (n=134).
Both surveys were completed by 118
participants, with the remaining participants
providing one response, but not both. Ordinal
data were compared using the Mann-Whitney U
Test and Chi Square was used for nominal data.
RESULTS
Camp participants were asked about
adequate rest on the pre/post survey to
determine if student camp schedule, combined
with student self discipline levels might create
differences in physical/vocal health due to lack
of sleep. However, mean sleep hours for each
previous night were pretest = 6.68 (prior to
camp activities) and the posttest =7.06 (after the
more strenuous days but prior to concerts).
Score ranges included pretest = 3 to 11 hours,
and posttest = 3-9 hours per night.
Campers were also asked to respond
YES/NO regarding any vocal difficulty at the
beginning of camp, with free response
opportunity to inform camp staff of any problems
requiring special accommodation. The posttest
survey also solicited this same information, and
a pre/post comparison indicated a significant
difference between those reporting vocal
difficulty upon arrival and those who departed
2
experiencing vocal difficulty [X (1, N=118) =
5.71, p, <.0169].
Table 1 provides comparisons between
responses to the 12 vocal health questions
asked prior to camp rehearsal and again after
camp concluded (except for two final concerts).
Responses to six questions did not change
across the week: those that asked about use of
voice in high and low ranges, dynamic control,
excessive throat clearing, and, self assessment
of how well each had taken care of the voice
throughout the week.
The six topics that
showed
significant
change
included:
hoarseness, U (125, 134) = 8084.5, p <.0001;
vocal tiredness, U (125, 134) =11418.5, p <
.0001; dryness, U (125, 134) = 10497.5, p <
.0004; throat pain, U (125,134) = 11157.5, p <
.0001; straining to sing, U (125, 134) = 11288.0,
p < .0001; and, effort to sing/breathiness, U
(125, 134) = 10981.0, p <.0001. Interestingly,
camp participants reported significantly more
vocal distress across the week, but indicated no
difference in how they cared for their voices.
Bowers/Daugherty (2008)
International Journal of Research in Choral Singing 3 (1)
Student Vocal Health 42
Table 1
Pre/Post Comparisons of Students’ Self Reported Vocal Health
Topic
Today, I can comfortably sing the higher notes of my voice range (Q1)
Today, I can comfortably sing the lower notes of my voice range (Q2)
Today, I can sing softly without any difficulty (Q3)
Today, I can sing loudly without any difficulty (Q4)
Today, my voice is hoarse (Q5)
Today, my voice feels tired (Q6)
Today, my voice sounds creaky and dry (Q7)
Today, my throat hurts when I sing (Q8)
Today, I feel like I’m straining when I sing (Q9)
I have taken good care of my voice this past week (Q10)
Today, I find myself clearing my throat a lot today (Q11)
Today, my voice is breathy and much effort for me to sing/talk (Q12)
DISCUSSION
Though one summer music camp is in no
way a sample reflecting all high school students
in other large group choral settings, the results
do raise some very important questions that may
well need to be asked of high school students in
general.
As noted by Deutsch (2002),
adolescent singers reported hoarseness and
fatigue as the most prevalent vocal problems
after extensive vocal use, and our study found
significant self-reported changes in hoarseness
and fatigue as well. These findings speak to
teacher responsibility, as often they control the
environment in which adolescents sing, and can
therefore monitor the vocal tasks and
responsibilities required of students.
Without additional study of vocal use of
adolescent singers, there can be no real
confirmation that vocal abuse occurs during
extended choral events. These studies need to
be done.
All state choirs, for example, abound, and
though outstanding experiences for young
singers, there is also opportunity for vocal
overuse and misuse by these young singers.
Vocal expectations during such events as
festivals and summer camps must also be
examined in more detail.
Within individual
school settings, teachers face decisions about
vocal use in music theater productions, jazz
ensembles, and a cappella groups, to name a
few. Undoubtedly, no teacher wants to
contribute to vocal harm of students in his or her
care. Only with straight-forward, objective
Mean Rank Scores
Pre
Post
132.3
124.5
130.9
129.2
138.4
122.2
136.3
124.1
105.7
152.7
91.5
166.0
113.0
145.8
107.7
150.8
106.7
151.7
130.0
130.0
124.6
135.0
109.3
149.3
z score
p
0.48
0.18
1.74
1.31
-5.05
-8.0
-3.52
-4.62
-4.83
0
-1.11
-4.3
.6312
.8572
.0819
.1902
.0001*
.0001*
.0004*
.0001*
.0001*
1.0
.2670
.0001*
analyses, however, will teachers and event
organizers know what boundaries should be
respected for singers of this age. Research is
long overdue in providing these guidelines.
Student perceptions of vocal health and
vocal responsibility, as well as accurate
knowledge of the voice, should be of concern to
teachers. Students seem to lack the knowledge
and perhaps the self-discipline required to
protect their own voices. When the enjoyment
factor is considered, and it is huge at such
things as all-state events and camps, then it is
not too surprising that students choose to “sing
until they drop.” It was astonishing to see six
significant variables related to voice overuse,
and yet have students report they had done well
at protecting the voice throughout the week.
Perhaps the first item to address is student
knowledge of the voice, with detailed information
about what SHOULD occur during intense vocal
use. One can only speculate, but perhaps
students view drinking water constantly (most
voluntarily did so) as sufficient vocal care.
Students surely will benefit from becoming more
independent in knowing what is vocally healthy
and what is not.
Two themes were apparent throughout this
study: teacher responsibility and student
vulnerability. Teachers spend limitless time
providing amazing music experiences for their
students. It would be valuable in choral settings
if guidelines based on empirical evidence could
be provided to help factor vocal health into this
process. Likewise, many students seem to have
limited knowledge of how their voices work, what
Bowers/Daugherty (2008)
International Journal of Research in Choral Singing 3 (1)
is required to protect the voice, and what should
be done when voice overuse or abuse actually
occurs. In other words, data from this study
suggest students lack sufficient knowledge and
independence to care for their voices. More
research is needed to guide the journey toward
Student Vocal Health 43
accurate understandings of potential student
vulnerability and the parameters of teacher
responsibility in contexts of intense, prolonged
choral singing experiences, such as those
provided by summer choral music camps.
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